L2: Infections in Immunocompromised Flashcards
Introduction to Immune System
Major Components of Specific Immunity
Markers of T-Suppressor Normally & in HIV
what stimulates both B & T Cells?
Clonal Selection
Def of Immunocompromised person
- Denoting an individual with deficient immunologic mechanisms either because of an immunodeficiency disorder or by immunosuppressive agents.
Def of Opportunistic
infection
- An infection by a microorganism that normally does not cause disease but becomes pathogenic when the body’s immune system is impaired and unable to fight off infection, as in AlIDS and certain other diseases
Suspicion of immunodeficiency disorder
Types of Immunodeficiency
1ry & 2ry
Nature of 1ry Immunodeficiency
Many of these disorders are hereditary and are autosomal recessive or X-linked.
Age in 1ry Immunodeficiency
Susceptibility to infections begins from childhood onward.
TTT of 1ry Immunodeficiency
The treatment of primary immunodeficiency depends on the nature of the defect, and may involve
Antibody infusions
Long-term antibiotics
Stem cell transplantation
Classification of 1ry Immunodeficiency
They are generally grouped by the part of the immune system affected such as lymphocytes, granulocytes, T cells and B cells.
Another Name of 1ry Immunodeficiency
Congenital
Types of 1ry Immunodeficiency
- Hemoglobinopathy
- Trisomy 21
- Complement Deficiency
- Phagocyte Deficiency
- B-Cell Deficiency
- T-Cell Deficiency
- Combined B&T Cell Deficiency
Def of Hemoglobinopathy
A kind of genetic defect that results in abnormal structure of one of the globin chains of the hemoglobin molecule
Infections in Hemoglobinopathy
- Common infectious agents are encapsulated organisms, particularly streptococcus pneumoniae.
- Others like salmonella sp., E-coli, H. Influenza, K. pneumonia, and Neisseria sp.
Infections Related to Trisomy 21
- Trisomy 21 are linked to otitis media and upper respiratory infections, as well as to infections with Candida.
Infections Related to Complement Deficiency
Cryptosporidia.
Meningococcal infections.
Invasive aspergillosis in immunocompromised patients.
Bancroftian Filariasis.
Phagocyte Deficiency
Infections Related to Phagocyte Deficiency
Infection Related to T-Cell Defects
Infections Related to B-Cell Defects
CP of Patients with B&T-Cell Defects
Infections Related to B&T-Cell Defects
Another Name of 2ry Immunodeficiency
Acquired
Causes of 2ry Immunodeficiency
Chronic Disease Causes of 2ry Immunodeficiency
CRF, LCF, DM
Meds Causing 2ry Immunodeficiency
- chemotherapy, anti TNF, PPI
- Immunosuppressive drugs and glucocorticoids after organ transplants
Toxins Causing 2ry Immunodeficiency
- Environmental toxins like mercury and other heavy metals, pesticides and petrochemicals
Cancers Causing 2ry Immunodeficiency
(leukemia, lymphoma, multiple myeloma).
Infections Causing 2ry Immunodeficiency
acquired immunodeficiency syndrome (AIDS) caused by the human immunodeficiency virus (HIV)
Infections Associated with Malnutrition
Infections Associated with Leukemia & Lymphoma
Infections Associated with Chronic Diseases
Infections Associated with LCF
E coli
Streptococci
S. aureus.
Infections Associated with DM
S. aureus infection
Candidiasis
Infections Associated with CRF
S aureus
S pneumoniae
E coli
Infections Associated with TTT & Meds
Infections Associated with drugs that decrease gastric acidity
- Salmonella sp.
- V. cholera
Infections Associated with inhibitors of TNF
TB, HSV, toxoplasmosis, CMV and activation of occult HBV or HCV.
Infections Associated with Cortecosteroids
S. aureus, S pneumoniae.
Infections Associated with inhaled corticosteroids
Oral candidiasis (thrush)
Community-acquired pneumonia (CAP)
Infections Associated with Ogan Transplant
Infections Associated with heart & Heart-Lung Transplant
Toxoplasma
Infections Associated with Renal Transplant
Adenovirus
Infections Associated with Stem Cell Transplantation
Infections Associated with asplenia
Polysaccharide encapsulated bacteria ( S pneumoniae )
Causes of asplenia
Splenectomy
Sickle cell anemia
What causes AIDS?
Caused by an infection by the HIV (Human immunodeficiency Virus), which attacks and destroys T helper cells.
types of HIV
Severity of HIV is determined by
viral load CD4+ counts
As the CD4 count declines, the immune function …..
decreases
INVs in HIV
HIV Chart
What Infection Happens in HIV when CD4 is lower than 400?
Herpes zoster & TB
What Infection Happens in HIV when CD4 is lower than 300?
Oral Candidiasis
What Infection Happens in HIV when CD4 is lower than 200?
- Pneumocystic Carinii
- Esophageal Candidiasis
- Mucocutaneous Herpes
What Infection Happens in HIV when CD4 is lower than 100?
Toxoplasmosis, Cryptococcosis, Coccidomycosis, Mycobacterium Avium, CMV
What Infection Happens in HIV when CD4 is lower than 50?
Cryptospeodiosis, PML
Examples of The oppurtunistic Infections in AIDS
Fungal Infections in AIDS
Parasitic Infections in AIDS
Bacterial Infections in AIDS
Viral Infections in AIDS
Pictures of Infections in AIDS
How to Delay Progression of AIDS?
Most AIDS patients usually died from……
infections rather than original disorder
…….. is the Most Important part in the treatment of immune deficient patients
Managing opportunistic infections
As a preventive measure, one must prevent these patients from getting exposed and getting the disease.
..
Criteria for Starting, Discontinuing, and Restarting Opportunistic Infection Prophylaxis for Adults with HIV
Sequelae of HIV
Sequelae of HIV
- After 4-6wks of infection
- Asymptomatic
- Persistent Generalized lymphadenopathy
Sequelae of HIV
- After few months & Years
AIDS related complex (ARC):
- Constitutional symptoms
- Minor opportunistic infections as herpes simplex & candida
AIDS: “end stage”
- Constitutional symptoms
- Major opportunistic infections as pneumocystistis carnii, pneumonia & Kaposi’s sarcoma
Dx of HIV
Clinical Dx of HIV
Lab Dx of HIV
